[procaare] UGANDA: Poor working conditions slow ARV rollout in war-ruined north

["IRIN PlusNews" <procaare@healthnet.org>]

UGANDA: Poor working conditions slow ARV rollout in war-ruined north
- IRIN PlusNews Aug 28
****************

KAMPALA, 28 August (PLUSNEWS) - Health workers in northern Ugandan have 
warned that treatment of HIV-positive people will be jeopardised unless 
working conditions for medical staff improve.

Qualified and committed staff are crucial to ensuring that patients 
understand and adhere to complicated antiretroviral drug regimens, but few 
like the idea of working in war-torn northern Uganda's refugee camps.

"There are skilled, knowledgeable staff in this country but they aren't 
willing to work in the camps," said Christine Schmitt, Head of Mission at 
international relief charity Medecins Sans Frontieres (MSF)-Holland.

The nationwide problem of poor, irregular remuneration, coupled with 
devastated health facilities, has meant that only eight of 15 
subcounty-level health centres in the northern district of Gulu have 
clinical officers, making antiretroviral (ARV) treatment nearly impossible.

"The proportion of HIV-positive patients being treated with ARVs is much 
lower in the north than in other areas. The demand is very high, but the 
drugs and the staff for follow-up are just not there," said Dr Jackson 
Ojera, Gulu coordinator for the United Nations Children's Fund (Unicef).

Patients need to take ARVs regularly and consistently to avoid developing 
drug-resistance and more frequent opportunistic infections.

Prevalence in the Gulu and Kitgum districts is nine percent, according to 
the government's 2004/05 National Sero Survey - three percent higher than 
the national average.

ARVs are free at government and NGO clinics, and at a charge from private 
clinics. Catholic Relief Services (CRS) provide anti-AIDS drugs from 
hospitals such as St Mary's Lacor in Gulu, St Joseph's in Kitgum and some of 
the larger camps.

NGOs plan to expand free care, but Schmitt admitted that MSF was struggling 
to find staff to man its new ARV programme in the northern Lira district.

According to Ojera, Unicef was extending ARV provision from towns and large 
camps to outlying areas, and "we planned to do that by the end of 2006 but I 
don't see that as being forthcoming - we just don't have the clinical 
officers."

[ENDS]

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